NCT04560387

Brief Summary

Obesity is a well-established risk factor for the development of atrial fibrillation (AF), while the reduction of body weight was shown to reduce the risk of AF. However, little is known about the effect of different weight-reducing interventions on AF burden. The study will evaluate the effect of a complex program aimed at weight reduction on AF burden in subjects after catheter ablation for AF and at least 1st degree obesity. This will be investigated in randomized study design and compared with patients receiving standard care without specific obesity-related intervention. The weight loss program will consist of diet, lifestyle and exercise counselling and, in selected subjects, also bariatric surgery in order to achieve a sustained weight loss of \>10% of initial body weight. Secondary aims include identification of patient phenotypes with the most benefits from weight reduction as well as elucidation of potential pathomechanisms linking obesity and AF, with the main focus being on low-grade inflammation. The project will help to define the optimal weight-reducing regimen in AF and to tailor the interventions to individual patient needs.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
160

participants targeted

Target at P50-P75 for not_applicable atrial-fibrillation

Timeline
Completed

Started Sep 2020

Longer than P75 for not_applicable atrial-fibrillation

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 10, 2020

Completed
11 days until next milestone

Study Start

First participant enrolled

September 21, 2020

Completed
2 days until next milestone

First Posted

Study publicly available on registry

September 23, 2020

Completed
4.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 31, 2024

Completed
8 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2025

Completed
Last Updated

October 30, 2020

Status Verified

October 1, 2020

Enrollment Period

4.1 years

First QC Date

September 10, 2020

Last Update Submit

October 28, 2020

Conditions

Outcome Measures

Primary Outcomes (1)

  • Atrial fibrillation burden

    Atrial fibrillation burden expressed as % of total monitoring time at final visit

    18 months

Secondary Outcomes (6)

  • Number of AF episodes on 14-day Holter monitoring

    18 months

  • Progressive reduction of AF burden between 12- and 18-month follow up visit

    18 months

  • hsCRP

    18 months

  • Epicardial adipose tissue volume

    18 months

  • Concentration of atrial natriuretic peptide (ANP)

    18 months

  • +1 more secondary outcomes

Study Arms (2)

Interventional

EXPERIMENTAL

Physician-lead complex program of weight-reducing interventions including education, diet counselling and regular physical activity aimed at achieving and maintaining a 10% reduction of baseline body weight. Bariatric surgery - sleeve gastrectomy in a subgroup of subjects with BMI \> 35 kg/m2, i.e. standard indication of bariatric surgery (patients with BMI \> 35 kg/m2 and a presence of metabolic or other complications).

Behavioral: Physician-lead complex program of weight-reducing interventionsProcedure: Bariatric surgery - sleeve gastrectomy

Conservative

NO INTERVENTION

Routine treatment of obesity

Interventions

A structured motivational and goal directed program will be used for weight reduction involving physicians, nutritionists, educators and physiotherapists. Initially, based on the input data provided by the patient an individual nutritional plan will be designed with the aim of reducing caloric intake by 10%. Low-intensity aerobic exercise for 30 min will be prescribed 3-times a week with the aim of increasing the frequency to 5-times a week and participants will be offered the possibility to participate in regular physiotherapist-lead group exercises. Patients will be required to maintain a diet and physical activity diary. Regular reviews will be scheduled every 3-6 months according to the actual weight loss.

Interventional

Bariatric surgery will be performed based on actual medical indication and independently of patient's participation in the study. Sleeve gastrectomy was selected as the currently most frequent restrictive type of bariatric surgery with a proven efficacy on weight reduction, metabolic status and low-grade inflammation

Interventional

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Paroxysmal or persistent AF scheduled for primary RF ablation
  • BMI ≥30 kg/m2
  • Age 18-70 years
  • Informed consent to the study

You may not qualify if:

  • Previous ablation for AF
  • left ventricular ejection fraction \< 40%
  • Left atrium diameter \> 55 mm
  • Active thyroid disease
  • Chronic kidney disease stage IV-V (eGFR \< 0.5 ml/s)
  • Chronic liver disease
  • Active malignancy
  • Inability to comply with study procedures

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Institute for Clinical and Experimental Medicine

Prague, 14021, Czechia

RECRUITING

Related Publications (1)

  • Stolbova K, Novodvorsky P, Jakubikova I, Dvorakova I, Mraz M, Wichterle D, Kautzner J, Haluzik M. Effect of Complex Weight-Reducing Interventions on Rhythm Control in Obese Individuals with Atrial Fibrillation Following Catheter Ablation: A Study Protocol. Adv Ther. 2021 Apr;38(4):2007-2016. doi: 10.1007/s12325-021-01667-0. Epub 2021 Mar 12.

MeSH Terms

Conditions

Atrial FibrillationObesity

Condition Hierarchy (Ancestors)

Arrhythmias, CardiacHeart DiseasesCardiovascular DiseasesPathologic ProcessesPathological Conditions, Signs and SymptomsOverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and Symptoms

Central Study Contacts

Kristyna Stolbova, MD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER GOV
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Prof. Martin Haluzik, DSc.

Study Record Dates

First Submitted

September 10, 2020

First Posted

September 23, 2020

Study Start

September 21, 2020

Primary Completion

October 31, 2024

Study Completion

June 30, 2025

Last Updated

October 30, 2020

Record last verified: 2020-10

Locations